Tuesday, January 29, 2013

THE MEDICATION CONUNDRUM









I was looking through papers. 
One in particular stood out. 
It was the flyer about medication. 


I've been looking at the medications that are currently used for the treatment of Fibromyalgia. Pain relievers, muscle relaxants, antidepressants and even anti-epileptic drugs. The approved drugs like Lyrica have side effects that can be serious.

So what are some of those medications?

I tried Lyrica and I still haven't lost all the weight I gained when I took that stuff. Not only do I hate the commercials but Lyrica made me squirrely. I gained weight (a lot), wondered if life was worth it and I couldn't trust my own mind. Even if it promised to take the pain away forever, I still wouldn't take it ever again. 

See, I will aways believe that Fibromyalgia has sub-groups. I have pain but not depression. I still feel that if depression accompanies the pain then Cymbalta or Savella may help and work for people in this group. It doesn't help me AT ALL. 

I have pain and terrible muscle spasms. I always say I'd take a baseball bat to my legs and beat the crap out of them because it would feel better than those stupid spasms. I take Zanaflex (tizanidine) and it does help. It helps normalize the amount of Substance P in the spinal fluid. Substance P is a neurotransmitter and it has been found that people with Fibromyalgia have an excess of Substance P in the spinal fluid. For me, it helps.

Back to the flyer.
It states that Zanaflex is ranked in the "poor" category.
I'll get back to that.

In the "excellent" category is Cymbalta, Lyrica, Savella and, funnily enough, Hydrocodone. Again, if you have pain and depression it's quite possible that these medications will help. The thing about hydrocodone, in my humble opinion, is that it isn't good for the long term. It is  usually combined with acetaminophen and there is a possibility of liver damage with long term use. The drugs in the excellent category in the flyer have weight gain as a side effect. I don't know about anyone else but pain is difficult enough to deal with.....

Weight gain?
Let's just add a tiara.

While I think the flyer gives good information about the approved medications that are used for Fibromyalgia, I think it's a mistake to rank them. The problem with Fibromyalgia is that this is a crap shoot. No one really knows what is going to work for whom. While a low dose opioid and tizanidine work for me to manage the symptoms, it may not work for someone else. 

Medications are tricky. They are to be used with caution. We have been made to believe that popping a pill will be magic. The pharmaceutical companies are big business and the side effects of the medications that we take are wide and varied. When I hear the disclaimers I think that the illness is almost better than what we have to take to manage it. Plus, they always talk REAL fast when they hit the real icky side effects. 

I think that sometimes we're being sold an illusion. They really don't know what these drugs can do. Is it possible, years from now, we will be told that these drugs are really not safe? I think there is a place for everything and we need a strategy that encompasses a pharma-exercise-alternative-behavioral-nutritional strategy. 

Let's face it, until they figure out what causes our pain perception and reception to go haywire......well then.......

We are where we are.

It the middle of the stream.

Reaching for any paddle that can get us to shore.







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